What are symptoms of alcohol use disorder?

A few mild symptoms — which you might not see as trouble signs — can signal the start of a drinking problem. It helps to know the signs so you can make a change early. If heavy drinking continues, then over time, the number and severity of symptoms can grow and add up to "alcohol use disorder." Doctors diagnose alcohol use disorder when a patient's drinking causes distress or harm. See if you recognize any of these symptoms in yourself. And don't worry — even if you have symptoms, you can take steps to reduce your risks.

In the past year, have you (check all that apply and click the "Feedback" button, below):

Had times when you ended up drinking more, or longer, than you intended?

More than once wanted to cut down or stop drinking, or tried to, but couldn't?

More than once gotten into situations while or after drinking that increased your chances of getting hurt (such as driving, swimming, using machinery, walking in a dangerous area, or having unsafe sex)?

Had to drink much more than you once did to get the effect you want? Or found that your usual number of drinks had much less effect than before?

Continued to drink even though it was making you feel depressed or anxious or adding to another health problem? Or after having had a memory blackout?

Spent a lot of time drinking? Or being sick or getting over other aftereffects?

Continued to drink even though it was causing trouble with your family or friends?

Found that drinking—or being sick from drinking—often interfered with taking care of your home or family? Or caused job troubles? Or school problems?

Given up or cut back on activities that were important or interesting to you, or gave you pleasure, in order to drink?

More than once gotten arrested, been held at a police station, or had other legal problems because of your drinking?

Found that when the effects of alcohol were wearing off, you had withdrawal symptoms, such as trouble sleeping, shakiness, restlessness, nausea, sweating, a racing heart, or a seizure? Or sensed things that were not there?

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The questions listed above are based on symptoms for alcohol use disorder in the American Psychiatric Association's Diagnostic and Statistical Manual (DSM) of Mental Disorders, Fourth Edition. The DSM is the most commonly used system in the United States for diagnosing mental health disorders.

How many "drinks" are in a bottle of wine?

A typical 25-ounce (750 ml) bottle of table wine holds about 5 "standard" drinks, each containing about 5 ounces. This serving size of wine contains about the same amount of alcohol as a 12-ounce regular beer or 1.5 ounces of 80-proof spirits.

Get to know what 5 ounces looks like by measuring it out at home. That way you can estimate how many standard drinks you're being served in a restaurant or bar that uses large glasses and generous serving sizes.

Mixing alcohol with certain medications can cause nausea, headaches, drowsiness, fainting, a loss of coordination, internal bleeding, heart problems, and difficulties in breathing. Alcohol can also make a medication less effective. For more information, see Harmful Interactions: Mixing Alcohol with Medicines.

Each year, an estimated 5,000 people under age 21 die from alcohol-related injuries.

The younger people are when they start to drink, the more likely they are to develop alcohol use disorder at some point in their lives.

Underage drinking is illegal—an arrest can lead to losing a job, a driver's license, or a college scholarship.

Even moderate amounts of alcohol can significantly impair driving performance and your ability to operate other machinery, whether or not you feel the effects of alcohol.

Heavy drinking during pregnancy can cause brain damage and other serious problems in the baby. Because it is not yet known whether any amount of alcohol is safe for a developing baby, women who are pregnant or may become pregnant should not drink.

Highest risk

About 50% of people who drink in this group have alcohol use disorder.

Increased risk

This "increased risk" category contains three different drinking pattern groups. Overall, nearly 20% of people who drink in this category have alcohol use disorder.

Low-risk drinking

Only about 2% of drinkers in this group has alcohol use disorder.

A U.S. standard drink contains about 0.6 fluid ounces or 14 grams of pure alcohol (also known as an alcoholic drink-equivalent). That's the amount in 12 ounces of regular beer, 5 ounces of table wine, or 1.5 ounces of 80-proof distilled spirits.

Distilled spirits include vodka, whiskey, gin, rum, and tequila.

Light to moderate drinking

Men: Up to 2 drinks per day

Women: Up to 1 drink per day

Heavy or at-risk drinking

Men: More than 4 drinks on any day or more than 14 drinks per week

Women: More than 3 drinks on any day or more than 7 drinks per week

Low-risk drinking

Men: No more than 4 drinks on any day and no more than 14 per week

Women: No more than 3 drinks on any day and no more than 7 per week

People with a parent, grandparent, or other close relative with alcoholism have a higher risk for becoming dependent on alcohol. For many, it may be difficult to maintain low-risk drinking habits.

Pace yourself: It's best to have no more than one standard drink per hour, with nonalcoholic "drink spacers" between alcohol beverages. On any day, stay within low-risk levels of no more than 4 drinks for men or 3 for women. Note that it takes about 2 hours for the adult body to completely break down a single drink. Do not drive after drinking.